MEDICARE: MS. STACY LYNN PARTON LCPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	180.003049	IL

General Provider Information

NPI Number	:	1558509232
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. STACY LYNN PARTON LCPC

Provider Business Mailing Address
First Line	:	1100 BEECH ST BLDG 7-3
Second Line	:
City	:	NORMAL
State	:	IL
Zip	:	61761-1534
Country	:	US
Telephone Number	:	309-340-9340
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 BEECH ST BLDG 7-3
Second Line	:
City	:	NORMAL
State	:	IL
Zip	:	61761-1534
Country	:	US
Telephone Number	:	309-340-9340
Fax Number	:	888-920-3465

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2009
Last Update Date	:	09/13/2023

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